The field of dietetics is becoming extremely important with the rise in obesity and other chronic diseases associated with obesity in the United States, such as diabetes and heart disease. A dietitian’s role is crucial in helping individuals with a variety of problems and diseases eat in a manner that produces the healthiest results. Dietitians may work in a wide variety of settings from hospitals to cardiac rehab centers and even eating disorder clinics. Let’s explore this exciting profession further.
What are some of the main responsibilities of a dietitian?
There are a variety of employment settings dietitians may work in and their role will vary accordingly. The clinical dietitian’s role is mainly nutrition screening, nutrition assessments, and patient education. Nutrition screenings look at the following factors: gender, age, height, weight, body mass index (BMI), diet, appetite, allergies, albumin, diagnosis/condition, and skin condition. Nutrition assessments look at the same items as the nutrition screenings plus lab values, medications, past medical history, and calculation of calorie, protein and fluid requirements. During nutrition assessments a care plan is established along with interventions such as nutrition education, change in diet, and the addition of nutrition supplements. Other tasks of a dietician include reviewing and interpreting patient lab values, documenting after each patient session, reading and analyzing patient histories (family, medical, dietary, etc).
Clinics and hospitals are the main employer for dietitians. Dietitians can work with inpatients or outpatients in a hospital setting. At larger hospitals there may be dietitians assigned specifically to just the in patient population and others who work solely with outpatients. Smaller hospital settings usually have a few dietitians who see both in and outpatients. Their daily patient load can vary widely based both on the type of individuals admitted to the hospital and the types of outpatients needing care.
An example of an outpatient needing the expertise of a dietitian is a diabetic whose physician refers him/her to a dietitian to help modify his/her diet in order to better control the diabetes. Other examples include individuals with digestive disorders, cardiovascular disease, or cancer. An example of an in-patient situation is a patient with who has undergone quadruple bypass or stroke. A dietitian would be flagged to work with the patient to show him/her how to follow a heart healthy diet and limit salt to prevent future problems from occurring. The dietitian would address recommendations aside from diet within the patient’s lifestyle as well such as the cessation of smoking and adding a daily exercise routine.
Some dietitians in inpatient facilities are more specialized, working in neonatal intensive care units (NICU) or as a feeding specialist. Feeding specialists are involved in both tube feedings, known as enteral, as well as vein feedings, known as parenteral. Enteral feedings are done through a tube inserted through the nose and ending in the stomach or a tube inserted through a surgical opening. A patient with head-neck cancer who is unable to chew or swallow due to radiation or surgery to the mouth or throat may require enteral feedings. Special formulas are designed to feed patients via a tube. The dietitian is responsible for determining the type and amount of formula necessary to meet the patients nutritional needs.
In terms of parenteral feedings, an example might be a trauma or burn patient who is unconscious and on a ventilator; unable to eat by mouth. The dietitian will calculate the amount of glucose, amino acids, and lipids needing to be fed through the vein to maintain the patient’s nutrition status until they are able to eat normally again.